Objective:
The study aimed to describe the identity and antimicrobial resistance patterns of the
causative agents of bacterial meningitis in children referred to Children’s Medical Center (CMC) Hospital,
Tehran, Iran.
Methods:
This retrospective study was performed at CMC Hospital during a six-year period from 2011 to
2016. The microbiological information of the patients with a diagnosis of bacterial meningitis was collected
and the following data were obtained: patients’ age, sex, hospital ward, the results of CSF and
blood cultures, and antibiotic susceptibility profiles of isolated organisms.
Results:
A total of 118 patients with bacterial meningitis were admitted to CMC hospital. Sixty-two percent
(n=73) of the patients were male. The median age of the patients was ten months (interquartile range
[IQR]: 2 months-2 years) and the majority of them (n=92, 80%) were younger than two years of age. The
highest number of patients (n=47, 40%) were admitted to the surgery department. Streptococcus
epidermidis was the most frequent isolated bacterium (n=27/127, 21%), followed by Klebsiella pneumoniae
(n=20/127, 16%), and Staphylococcus aureus (n=16/127, 12.5%). Blood culture was positive in 28%
(n=33/118) of patients. Ampicillin-sulbactam and imipenem were the most effective antibiotics against
Gram-negative bacteria isolated from CSF cultures. In the case of Gram-positive organisms, ampicillinsulbactam,
vancomycin, and linezolid were the best choices. Imipenem was the most active drug against
Gram-negative blood pathogens. Also, ampicillin and vancomycin had the best effect on Gram-positive
bacteria isolated from blood cultures.
Conclusion:
Results of this study provide valuable information about the antibiotic resistance profiles of
the etiologic agents of childhood meningitis, which can be used for prescription of more effective empirical
therapies.
Regional Dissemination of a Carbapenemase-encoding Plasmid: Plasmidome analysis Reveals Diverse Adaptations of Carbapenemase-Producing Enterobacteriaceae